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Postnatal weight growth trajectory in infants born between 30 4/7 weeks and 34 3/7 weeks of gestation

Journal of Perinatology volume 44, pages 575–577 (2024)Cite this article

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The use of intrauterine growth reference charts for growth assessment in neonatal intensive care units (NICUs) has been established for decades. Historical references date back to 1963, with a study published by Lubchenco et al. evaluating the birth weights of 5,635 live-born Caucasian infants with a gestational range of 24 to 42 weeks [1]. More recent advancements include the growth charts published by Fenton and Kim in 2013, the result of a meta-analysis of six published studies [2]. An additional contribution to growth reference for preterm infants comes from the INTEGROWTH-21st project, which developed growth standards based on the measurements of relatively uncomplicated infants born at 24 weeks of gestation or later [3].

While intrauterine growth charts have aligned with the goal set forth by the American Academy of Pediatrics in 1977 to promote postnatal growth rates similar to those experienced in utero [4], it is evident that intrauterine growth and postnatal growth follow distinct trajectory patterns. Recently, we systematically assessed postnatal growth in infants born between 22 4/7 and 30 3/7 weeks of gestation, revealing notable differences between postnatal and intrauterine growth patterns [5]. We identified three distinct phases of postnatal weight growth: the weight loss phase, the weight acceleration phase, and the stable weight gain phase. These phases were not observed during intrauterine growth.

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Fig. 1: Plots of the modeled growth estimates and the growth rate estimates.

Data availability

The growth chart data are available publicly by visiting https://nicugrowth.app.

References

  1. Lubchenco LO, Hansman C, Dressler M, Boyd E. Intrauterine growth as estimated from liveborn birth-weight data at 24 to 42 weeks of gestation. Pediatrics. 1963;32:793–800.

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Acknowledgements

The authors would like to thank Dr. Tanis R. Fenton, PhD RD of University of Calgary for sharing the LMS table of the 2013 Fenton growth charts for plotting use in this work.

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Authors and Affiliations

  1. Department of Neonatology, Kaiser Permanente Riverside Medical Center, Riverside, CA, USA

    Fu-Sheng Chou

  2. Southern California Permanente Medical Group, Pasadena, CA, USA

    Fu-Sheng Chou

  3. Division of Health Services and Outcomes Research, Children’s Mercy Research Institute, Kansas City, MO, USA

    Hung-Wen Yeh

  4. Department of Pediatrics, School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA

    Hung-Wen Yeh

  5. Center for Research, Education, Quality and Safety, Pediatrix Medical Group, Sunrise, FL, USA

    Reese H. Clark

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  1. Fu-Sheng Chou
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  2. Hung-Wen Yeh
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  3. Reese H. Clark
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Contributions

F-SC led the study design and the analysis, and drafted the initial manuscript and the revised manuscript. H-WY supervised study design and the analysis, and drafted the initial manuscript. RHC supervised study design, supplied measurement data for the analysis from the Pediatrix® Clinical Data Warehouse, and drafted the initial manuscript. All authors contributed to the interpretation of the results and critically reviewed and redrafted the manuscript.

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Correspondence to Fu-Sheng Chou.

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Chou, FS., Yeh, HW. & Clark, R.H. Postnatal weight growth trajectory in infants born between 30 4/7 weeks and 34 3/7 weeks of gestation. J Perinatol 44, 575–577 (2024). https://doi.org/10.1038/s41372-023-01837-8

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